Kudedera uye Kudedera Kwakakosha

Clinical Overviews

Essential Tremor

Essential tremor (ET) ndiyo inonyanya kuzivikanwa tremor syndrome inowanikwa muvakuru. Essential tremor inguva yakasarudzika yekudengenyeka kwemakumbo maviri ekumusoro kwemakumbo chiito kudedera kwenguva inokwana makore matatu, sezvakatsanangurwa nguva pfupi yapfuura neMDS Task Force for Tremor. Kudedera mune dzimwe nzvimbo (semuenzaniso, musoro, izwi, kana makumbo ezasi) anogona (kana kusavapo) aripo. Asi hapana zvimwe zviratidzo zvetsinga, senge dystonia, ataxia, kana parkinsonism. Kuti uwedzere kujekesa uye kutsanangura ET kubva kune kumwe kudengenyeka, maitiro ekuregererwa akaumbwawo: Nokudaro, kudengenyeka kwepamusoro-soro (inzwi, musoro), orthostatic kudengenyeka nefrequency> 3 Hz, basa- uye chinzvimbo-chaicho kudedera uye kungoerekana kwatanga uye nhanho-huchenjeri kuderera hakuwire muchikamu cheET.

Ona tsananguro yakazara

Kudengenyeka kwehunhu kunoonekwa muET ndeye postural uye chiito kudedera, ine frequency ye4-7 Hz. Kudengenyeka uku kunogona kutanga kusinganzwisisike pakutanga kwehupenyu, nekuwedzera kwekutyisa kwekufamba kwemakore. Kuremara muET kunobatanidza nekukanganiswa kwemabasa ekuzvidira anoitika semugumisiro wekudengenyeka. Varwere vanowanzonyunyuta nezvekudedera pavanenge vachidya, vachinwa uye vachinyora, vachiteura chikafu nezvinwiwa uye kugadzira runyoro rusingaverengeki. Nhengo dzemuviri dzinowanzobatwa nemaoko dzinosanganisira maoko, musoro uye inzwi, asi zvinogona kuonekwawo mumakumbo, hunde uye kumeso.

Pasinei nekunyanya kudengenyeka kwemashure, kudengenyeka kwekinetic kunogona kunge kuripo uye dzimwe nguva kudengenyeka kwekuzorora kwekunyanya kuderera kunogona kukosheswa. Kudengenyeka kweET kunowedzera nemamiriro ezvinhu sekushungurudzika, kurovedza muviri uye kuneta, caffeine, mamwe mishonga uye inovandudza nekuzorora uye zviduku zvedoro. Varwere kazhinji vane nhoroondo yemhuri.

Mishonga yakajairika yeET inosanganisira: beta blockers senge proporanolol, primidone uye topiramate. Dzimwe nguva, mumishonga-refractory kudengenyeka, kudzika kweuropi kukurudzirwa kweVIM nucleus yethalamus inofungidzirwa.

Yakanyorwa naHubert Fernandez, MD
Musoro, Movement Disorders
Dhipatimendi reNeurology
Cleveland Clinic
Cleveland, Ohio USA

Yakagadziridzwa 2019: Yakanyorwa naSusan A. Schneider, MD
Consultant Neurologist
University Hospital Munchen
Pullach, Germany

Kupopota

Kudedera ndiko kufamba kusingaite, mutinhimira, kutenderera kwechikamu chemuviri. Kudengenyeka kunobva pazvisungo zveagonist uye antagonist tsandanyama dzakapinzwa nechiratidzo chechiratidzo chinobva kune oscillator mukati mepakati tsinga system. Kudengenyeka kwekuzorora kunoitika munhengo yemuviri isina kuvhurwa uye inotsigirwa zvakakwana kurwisa simba rinokwevera zvinhu pasi. Kudengenyeka kweAction kunoreva kudedera kunoitika nekuzvidira kudhonzwa kwemhasuru uye kwakakamurwa kuita postural tremor, isometric kudedera uye kinetic kudedera. Iyo yekupedzisira inopatsanurwa zvakare kuita kinetic yakapfava, kudengenyeka kwechinangwa, uye basa chairo kudedera, sekunyora kudedera.

Ona tsananguro yakazara

Etiology yekudengenyeka kwakasiyana, uye inosanganisira kudengenyeka kwakakosha (ine 50% ine FH yakanaka asi pasina gene rimwe rakaonekwa); sechikamu chezvirwere zvemajini eg chirwere chaWilson; kuora mwoyo kwakadai sechirwere cheParkinson, zvirwere zveMetabolic (zvakadai sethyroid-, parathyroid-, chirwere chechiropa uye hypoglycemia); peripheral neuropathies (eg inobatanidzwa neCharcot-Marie-Tooth; zvinodhaka-induced (kusanganisira narcoleptics, tricyclics, lithium, cocaine, doro, adrenaline, bronchodilators, theophylline, caffeine, steroids, valproate, amiodarone, thyroid hormones, vincristinevy metalfuncristine) uye psychology psychristine; kusagadzikana.

Zvinodiwa pakutanga zvakabvumidzwa neMDS kubva muna 1998 zvakagadziriswazve munguva pfupi yapfuura kuti zvikunde zviri nani kusawirirana, kunyanya maererano ne essential tremor (ET), tremor inobatanidzwa ne dystonia kana zvimwe zvirwere zvetsinga, uye focal tremor. Kubvumirana kutsva kunoratidza kuti kupatsanurwa kune zvikamu zviviri zvikuru: zviratidzo zvekiriniki (Axis 1) uye etiology (Axis 2).

Mumakiriniki, chirwere chinosanganisira kudedera chete chinonzi isolated tremor syndrome. Kune rumwe rutivi, chirwere chinosanganisira kubvunda uye zvimwe zviratidzo zve systemic kana zvetsinga zvinodaidzwa kusanganisa tremor syndrome.

Etiologically, kudedera kunogona kurongerwa kuva kudengenyeka kwemuviri, kuwedzeredzwa kwekufamba kwemuviri, kwakakosha kubvunda syndromes (kusanganisira classical ET), dystonic tremor, parkinsonian kudengenyeka, cerebellar kudengenyeka (kunowanzobatanidzwa nemultiple sclerosis), Holmes 'kudedera (aka rubral tremor), palatal kudengenyeka, neuronduced kudengenyeka, neurotoxic kudengenyeka psychogenic kudedera.

Yakapihwa naLeo Verhagen, MD, PhD
Batanidza Purofesa weNeurological Sayenzi
Rush University Medical Center
Chicago, IL, USA

2019 Updates Inopihwa na:

Susanne A. Schneider, MD
Consultant Neurologist
LMU University Hospital Muenchen
Munich, Germany

Susan Fox, MRCP (UK), PhD
Purofesa weNeurology
Yunivhesiti yeToronto, Toronto Western Hospital
Toronto, ON, Canada

Mazano Anokosha

mabatiro

MDS Evidence-Yakavakirwa Mushonga Ongororo: Kurapa kweEssential Tremor (2026)

Verenga EBM ongororo

kuongorora chirwere

Chirevo cheKubvumirana pane kurongeka kwekudengenyeka: Kubva kuMDC Task Force pakudengenyeka (2017)

Verenga bepa

dzidzo

Chekutanga Coursework

Tremor Curriculum Tracks

Curated seti yezvidzidzo uye zvinhu zvinokutungamira zvishoma nezvishoma kuburikidza neTremor misoro.

Ona mafambiro ekudengenyeka

Zvinokosha: Kusvika kune Kudedera

Dzidza nezvekudengenyeka kwemhando, yekutanga pathophysiological kumashure, uye kusiyanisa kuongororwa kwemhando dzekudengenyeka, pamwe neazvino nzira dzekurapa.

Tarisa kosi